Significance of oxidative stress and antioxidant capacity (d-ROMs and BAP) tests as biomarkers of premature ovarian insufficiency: a case-control study

Abstract Background: Premature ovarian insufficiency (POI) is a condition that causes secondary amenorrhea due to ovarian hypofunction at an early stage (before the age of 40). Early follicular depletion results in not only increased morbidity of lifestyle diseases such as osteoporosis, myocardial infarction, and cerebral infarction due to low estrogen levels but also intractable infertility, thereby significantly reducing women’s quality of life. Given the continuum in weakened ovarian function, progressing from incipient ovarian failure (IOF) totransitional ovarian failure (TOF) and further to POI, it is necessary to develop biomarkers for predicting POI. There is a continuum of weakened ovarian function IOF, TOF, and transition to POI when it progresses. In contrast, it has been suggested that mitochondrial function in eggs and cytotoxicity caused by accompanying reactive oxygen are factors that contribute to decreased remaining follicle count and egg quality owing to ovarian hypofunction. By comprehensively evaluating the oxidative stress state in IOF and POI from both oxidative stress (diacron-reactive oxygen metabolites [d-ROMs]) test and antioxidant capacity (biological antioxidant potential [BAP]), this study aims to explore their possibilities as biomarkers for early detection of POI. Methods: Among women under the age of 40 who visited our hospital from January 2021 to June 2022, we recruited 11 women in the POI group and 11 women in the IOF group, in addition to normal women of the same age in the control group, and measured their plasma d-ROMs and BAP. Results: d-ROMs of the IOF and POI groups were both significantly higher than those of the control group (p < 0.001). No significant difference was found between the three groups in BAP. Oxidase stress indexes (d-ROMs/BAP x 100) of the IOF and POI groups were significantly higher than those of the control group (p < 0.001). Conclusion: Oxidative stress (d-ROMs and oxidative stress index) levels of the IOF and POI groups were significantly higher than those of the control group, suggesting that the evaluation of the oxidative stress state is useful as an indicator for the early detection of POI.